Clinical Profile and Ocular Manifestations of Insect Trauma: A Case Series with Management Protocol at a Tertiary Eye Care Center

Background: Ocular trauma by insects is a rare environmental hazard and is commonly observed in patients engaged in outdoor activities, agricultural workers, and rural inhabitants. Having good diagnostic knowledge and a uniform algorithm for the treatment of such trauma can not only lead to better management but also timely rehabilitation of the patients. Retained insect parts are usually very tiny, with surrounding inflammatory reactions often being missed on slit lamp examination. Since this form of trauma is relatively uncommon, there is no uniform treatment regimen for the same. Materials and Methods: A prospective interventional case series was conducted at a tertiary eye care center in central India from January 2018 to January 2019. Forty-six consecutive patients with a clinical history and symptoms of ocular trauma due to insects were included. A management protocol was created based on analyzing the clinical picture and treatment response in the included patients. Results: Thirty-five (76%) were male, and 11 (24%) were female, with a mean age of 40.44 ± 14.25 years (19–65). Thirty-four (73.9%) patients gave a history specific to trauma by insects, and trauma while performing outdoor agricultural activities ( n = 15, 32.6%) was the most common cause. The median time of presentation was 7 days (range − 1–90 days). Part of the insect was noted lodged in 20 (43.4%) eyes. Most patients were treated with antimicrobials and antifungals, with steroids being selectively used in 15 cases only. Conclusion: Insect trauma is most commonly seen in rural settings, especially in males involved with agricultural work. The time and mode of presentation and response to treatment may significantly vary for every case. Prompt removal of any Insect part and treatment with appropriate antimicrobials is usually sufficient for early recovery.